When it comes to health care overhauls, it's a crazy mixed up world. When you take a close look at Paul Ryan's plans for Medicare, they look a lot like key provisions of Obamacare, which he and Mitt Romney promise to repeal.

What's striking about Ryan's plan for Medicare (a.k.a. The Path to Prosperity) is how similar it is to Obamacare. Under the Ryan plan, after 2022 new enrollees would have to choose between Medicare and a private insurance plan. Medicare essentially becomes the "public option" that Republicans opposed so vehemently when it was proposed as part of Obamacare.

In addition, people would have the option of choosing between Medicare insurance exchanges, which look for all the world like the exchanges to be set up under Obamacare that Republican governors like Scott Walker now refuse to establish in the hopes that Obamacare will be repealed if Romney and Ryan are elected.

Paul Ryan promises to "end Medicare as we know it." The question is why? What's the problem Ryan is trying to solve?

Medicare is more efficient than private insurance. Costs under Medicare have increased by an annual average of 4.3% over the last decade compared to 6.5% for private insurance.

And the nonpartisan and respected Congressional Budget Office, in response (PDF) to request for an analysis of his plan by Ryan himself, concluded:

Under the proposal, most elderly people would pay more for their health care than they would pay under the current Medicare system.

Ironically, the thing I find most disappointing about Obamacare is the lack of the very public option that Ryan would create in his plan for Medicare.

Rather than messing with something that isn't broken, the better strategy would be to go the other way: simply extend the successful Medicare program to everyone and be done with it.

Instead of having a debate over how to mess up a successful program, why aren't we debating its extension to everyone?